I also start by acknowledging the Wurundjeri people, the traditional owners of the land on which we meet, and pay my respects to elders past and present.
And I thank the Melbourne Institute and The Australian for the opportunity to address this forum of great discussion and debate on the policies that not only guide Australia’s economic future but speak to our collective values as a fair and just society.
I am very pleased to share the stage with serious thinkers like Bruce Bonyhady and Sam Paior in a session devoted to National Disability Insurance Scheme.
NDIS has been operational since May 2013 and is arguably the biggest Commonwealth achievement this century – one that is a world leader by any measure.
But right now, this great scheme is neither as effective nor equitable as I believe it should be.
For many NDIS participants it’s working well and is life changing.
But for too many others it is tiring, there is too much red tape and uncertainty.
For many, the NDIS is not trusted. And it is growing in cost too fast.
Labor said before the election that we’d change that. We are changing that. And we’re changing it based on three principles.
Building a more effective NDIS that invests in outcomes for participants.
Restoration of trust in the scheme.
And moderation of cost growth.
Building an effective NDIS
So the first principle.
Getting the NDIS working effectively to improve outcomes for participants.
The scheme needs to get back to an investment approach to supporting people with disability.
If we invest effectively – break down barriers that prevent people with disability from participating in social and economic life – we also generate an investment return for the community.
Measuring and reporting on outcomes allows us to make the NDIS more effective and sustainable. But, to date, there has been insufficient examination of the Scheme through an investment lens.
What we do know is that the NDIS has already improved workforce participation for participants and their families.
More than twice as many participants aged 15 to 24 are working than before they entered the Scheme.
And we know that parents with a child who is part of the NDIS report a 24% increase in employment.
But it’s not just participants and their families who will be able to contribute to the Australian workforce. The disability workforce is vital and will only grow to support the scheme.
The DSS 2021-2025 NDIS Workforce Plan anticipates 83,000 disability workers by 2024 and 213,000 replacement workers over that same period.
A Per Capita report puts the return on investment in the NDIS at $2.25 for every dollar spent.
An effective NDIS therefore has the dual attribute of improving outcomes for participants and their families and reducing avoidable cost to governments in terms of social security, employment, housing, health, and future NDIS costs.
An avoidable cost I was surprised to learn about just after our return to office was that approximately 1,400 people with disability were stuck in hospital even though medically fit for discharge.
The cost to the taxpayers and health system for these excessive long stays, on top of the costs to the states and territories, was hundreds of millions of dollars each year.
It’s pretty simple. People medically fit for discharge should not be kept languishing in hospital.
It is the wrong setting, leads to poor health outcomes for people with disability, and is massively expensive.
I have focussed on working with the states and territories to ensure safe and timely hospital discharge.
The NDIA has been implementing an initial plan with some early success.
We now have 50 Hospital Liaison Officers nationally working with states and territories to “wrangle” support and accommodation teams.
In addition, we now have 54 dedicated specialist Hospital Discharge Planners endowed with greater delegation and decision-making powers to get things done at a local level.
Since we introduced these changes, 309 people, previously stuck in hospital, have been discharged.
This saves the health system around $750,000 a day and, as we know, beds are always at a premium for those who need the highest level of medical care, even more so during COVID.
But most importantly, those 309 people are achieving better outcomes because they’re no longer left languishing in hospital.
Restoring trust
Our second guiding principle is about rebuilding community trust in the scheme.
Putting people with disability front and centre of decision making is a start. It ensures the NDIS is on the right path if we listen to those who know better than anyone what needs to be done.
I’ve appointed Kurt Fearnley – Australian Paralympic legend and disability advocate – as Chair of the NDIA Board.
And we’ve welcomed to the NDIA Board Dr Graeme Innes, former Australian Human Rights Commissioner, and Ms Maryanne Diamond – the inaugural CEO of the Australian Federation of Disability Organisations.
These are people with lived experience of disability and a wealth of knowledge from roles in the corporate and public sectors. People whose insights are invaluable.
With five people from the disability community now on the NDIA Board– the greatest number in its history so far – I am so far optimistic that we will quickly see the difference that this depth of representation makes.
We will also fix the funding constraint on the NDIA by preventing a $385m funding cliff next year, and unshackle the agency and NDIS participants from labour hire firms and contractors.
We also want to restore the trust of the most marginalised Australians who aren’t getting proper access to services – including First Nations peoples and people with a disability in regional and remote areas.
We need a more flexible approach, and we need to support the NDIA to play a greater role of market stewardship than previously.
I can today announce we will appoint a senior executive role for Market Stewardship, to oversee market interventions, pricing, and mainstream services.
This will be a significant appointment and one which will make a real difference to the lives of many.
It will also help NDIA to work more closely with states territories.
For example, we need the schools system to do more for the spiralling numbers of children with developmental delay entering the NDIS – more than 47,000 at the end of June.
The NDIS cannot be the only lifeboat in the ocean.
Moderation of growth – curbing growth, not cost-cutting
Part of restoring trust involves making good on our promise to target waste and fraud.
Which brings me to the third principle that is guiding our mission to fix the NDIS – moderation of cost growth. Curbing growth in cost, rather than blunt force cuts that are not strategic.
Australians back the NDIS but expect that the money meant for the person with disability is not syphoned off or squandered.
An assessment of the NDIS conducted by the Australian Criminal Intelligence Commission found the scheme is being targeted by organised crime entities.
Stealing from vulnerable Australians is one of the lowest acts imaginable and I just won’t have it.
The serious nature of this attack on the NDIS will be met with an equally serious response.
Last Tuesday’s Budget delivered a total of $137.7 million to better safeguard the scheme from organised crime, including through the establishment of a long overdue Fraud Fusion Taskforce – to be co-chaired by the NDIA and Services Australia.
The NDIA, the NDIS Commission, the Australian Tax Office, the Australian Federal Police and my other portfolio department of Services Australia are just a few of the agencies which will work in lockstep to share information to find these crooks.
Because the former Government has not done fraud-fighting properly for the better part of a decade, we know anecdotally it’s a big problem – just not how big.
We’re like a fisherman who doesn’t know the size of his catch until he starts reeling it into his boat. But I suspect it’s a very big fish. And in the words of Roy Scheider in Jaws we’re “gonna need a bigger boat.”
But, we’ll uncover these unscrupulous individuals and groups and they will be prosecuted.
We promised to crack down on fraud and waste and we’re doing it.
People with disability are not to blame.
I want to be crystal clear about something today. People with disability are not to blame for any inadequacies in the current design of the NDIS.
It has led to a scheme where providers have incentives to deliver more services, rather than outcomes for participants.
I have already established and brought forward by a year the NDIS Review. It will be co-chaired by Professor Bonyhady and well-respected former Commonwealth secretary Lisa Paul, working with a well-resourced secretariat lead by senior Treasury official, James Kelly, located in Prime Minister and Cabinet.
This engagement from central agencies reflects the priority and importance with which the Prime Minister and Treasurer regard this review, and the reforms that will follow it.
This root and branch review will bring together experts, including people with disability, to examine the design, operation and sustainability of the NDIS. To see where the Scheme has gone wrong and propose solutions.
And we will continue to build on the promises we’ve already delivered – adding an extra 380 permanent staff to the NDIA; doubling the funding for systemic advocacy; reducing the 4,500 case backlog of appeals before the AAT by 2000 cases.
We will get this crucial scheme back on track.
Ultimately it is about more than ROI or GDP, it is about people.
And people with disability and their families deserve the chance to reach their potential – to live an ordinary life – and it is incumbent upon us to give them that opportunity.